Larngeal function preserving surgery in hypopharyngeal carcinoma
10.3760/cma.j.issn.1673-0860.2009.06.007
- VernacularTitle:保留喉功能喉咽癌的手术切除与修复
- Author:
Jia-Xi LI
1
;
Xing-Ru LI
;
Gao SUN
;
Bo QU
;
Hui WANG
;
Song DAI
;
Zhi-Xiang GUO
Author Information
1. 解放军第463医院
- Keywords:
Hypopharyngeal neoplasms;
Carcinoma,squamous cell;
Pharyngectomy;
Laryngectomy;
Survival rate;
Prognosis
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2009;44(6):469-474
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the preservation of laryngeal function hypopharyngeal cancer surgery clinical effectiveness and impact of prognostic factors. Methods A retrospective analysis in September 1974 - July 2003 treated 45 cases of hypopharyngeal cancer surgery retain the clinical treatment of laryngeal function effect. Among them there were 23 cases of original pyriform sinus cancer,13 cases of post cricoid cancer and 9 cases of postero pharyngeal wall cancer. Two cases of preoperative radiotherapy, radiotherapy volume of 40 -50 Gy; after 32 cases of radiotherapy, radiotherapy dose of 60 -70 Gy. Analysis of impact on survival in patients with risk factors. Results Forty five cases of preservation of laryngeal function after 88. 9% who articulate pronunciation ambiguities were mild 11.1% ; 23 cases of tracheostomy tube removal, decannulation rate was 51.1%, all can eat into the cape. Nineteen cases of post-operative complications (42. 2% ) ; after 20 cases of cervical lymph node metastasis, accounting for 44. 4%. Statistics Kaplan-Meier method in patients with the whole group 5-year survival rate was 53.3%. T1 + 'T2 and T3 + T4 patients after 5-year survival rates were 66.7% and 43.3% ; cN0 and cN1, cN2 group survival rates were 65. 2% and 46. 7%, 28. 6% ; pathological differentiation of high, medium and low-group survival rates were 62. 3%, 42. 1% and 30. 8%. Single-factor analysis of survival and whether pre-operative cervical lymph node metastasis and the degree of pathological differentiation (x2 value of 5. 297 and 11. 556, P value of 0. 021 and 0. 003). Multivariate Cox regression analysis showed that the availability of pre-operative cervical lymph node metastasis and pathological effects of the degree of differentiation is an independent risk factor for prognosis (x2 value of 4. 365 and 4.600, P value of 0.041 and 0.032, OR value of 1. 151 and 0.610). Conclusions Preservation of laryngeal function hypopharyngeal cancer surgery for T1, T2 patients with the best surgical procedures, some of T3, T4 advanced hypopharyngeal cancer can also be used to retain the operation of laryngeal function; and preservation of laryngeal function can not affect the prognosis of patients with.
